- Amar Dhillon, pathologist1
- 1Department of Cellular Pathology, UCL Medical School, Royal Free Campus, London NW3 2PF, UK
The reappearance of some of my histology grading sheets for the Wakefield study is interesting.1 2 I have not seen them since 1997-8, when I gave them to Andy Wakefield. The BMJ’s articles on these grading sheets in the issue of 12 November show several misunderstandings.3 Many are a result of a lack of understanding of the difference between, on the one hand, the systematic documentation of specific microscopical features in a grading sheet by a “blinded” pathologist and, on the other, conclusion of an overall clinicopathological diagnosis by integrating clinical information with diverse lines of investigation. The difference between the two activities should be understood better.
Routine diagnostic histopathology is done with knowledge of an individual patient’s clinical details at the time of diagnostic reporting, so rendering a diagnostic histopathological opinion is usual and appropriate (in direct contrast to a blinded research review). The perceived clinical significance of microscopic observations may change as …